Self-exposure therapy for panic disorder with agoraphobia

2001 ◽  
Vol 178 (4) ◽  
pp. 331-336 ◽  
Author(s):  
L. M. Ito ◽  
L. A. De Araujo ◽  
V. L. C. Tess ◽  
T. P. De Barros-Neto ◽  
F. R. Asbahr ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Post Treatment ◽  
Control Group ◽  
Control Subjects ◽  
Short And Long Term ◽  
Post Entry ◽  
Randomised Controlled ◽  
Interoceptive Cues

BackgroundExposure to external phobic cues is an effective therapy for panic/agoraphobia but the value of exposure to interoceptive cues is unclear.AimsRandomised controlled comparison in panic/agoraphobia of the effects of (a) external, (b) interoceptive or (c) combined external and interoceptive self-exposure to (d) control subjects.MethodEighty out-patients were randomised to a control group or to one of three forms of self-exposure treatment (external, interoceptive, or combined). Each treatment included seven sessions over 10 weeks and daily self-exposure homework. Assessments were at pre- and post-treatment and up to 1 year post-entry. Assessors remained blind during treatment.ResultsThe three self-exposure groups improved significantly and similarly at post-treatment and up to 1-year follow-up, and significantly more than did the control subjects. Rates of improvement on main outcome measures averaged 60% at post-treatment and 77% at follow-up.ConclusionsThe three methods of self-exposure were equally effective in reducing panic and agoraphobic symptoms in the short- and long-term.

scholarly journals Nurse-based secondary preventive follow-up by telephone reduced recurrence of cardiovascular events: a randomised controlled trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anna-Lotta Irewall ◽  
Anders Ulvenstam ◽  
Anna Graipe ◽  
Joachim Ögren ◽  
Thomas Mooe
Keyword(s):  
Randomised Controlled Trial ◽  
Primary Endpoint ◽  
Cardiovascular Events ◽  
Controlled Trial ◽  
Control Group ◽  
Coronary Syndrome ◽  
Secondary Endpoints ◽  
Randomised Controlled

AbstractEnhanced follow-up is needed to improve the results of secondary preventive care in patients with established cardiovascular disease. We examined the effect of long-term, nurse-based, secondary preventive follow-up by telephone on the recurrence of cardiovascular events. Open, randomised, controlled trial with two parallel groups. Between 1 January 2010 and 31 December 2014, consecutive patients (n = 1890) admitted to hospital due to stroke, transient ischaemic attack (TIA), or acute coronary syndrome (ACS) were included. Participants were randomised (1:1) to nurse-based telephone follow-up (intervention, n = 944) or usual care (control, n = 946) and followed until 31 December 2017. The primary endpoint was a composite of stroke, myocardial infarction, cardiac revascularisation, and cardiovascular death. The individual components of the primary endpoint, TIA, and all-cause mortality were analysed as secondary endpoints. The assessment of outcome events was blinded to study group assignment. After a mean follow-up of 4.5 years, 22.7% (n = 214) of patients in the intervention group and 27.1% (n = 256) in the control group reached the primary composite endpoint (HR 0.81, 95% CI 0.68–0.97; ARR 4.4%, 95% CI 0.5–8.3). Secondary endpoints did not differ significantly between groups. Nurse-based secondary preventive follow-up by telephone reduced the recurrence of cardiovascular events during long-term follow-up.

scholarly journals Testing the Efficacy of ‘Unlearning’, a Mindfulness and Compassion-Based Programme for Cultivating Nonviolence in Teenagers: A Randomised Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Irene Delgado-Suárez ◽  
Yolanda López-del-Hoyo ◽  
Javier García-Campayo ◽  
Adrián Pérez-Aranda ◽  
Marta Modrego-Alarcón ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Multiple Comparisons ◽  
Post Treatment ◽  
Control Group ◽  
Self Compassion ◽  
Baseline Levels ◽  
Secondary Outcomes ◽  
Randomised Controlled

Background: Most programmes developed to reduce aggressive attitudes among teenagers are based on cultivating nonviolence, a construct that has been related to compassion and, more indirectly, mindfulness. This study aims at testing the efficacy of ‘Unlearning’, a mindfulness and compassion-based programme, for reducing aggressive attitudes in adolescents.Method: A sample of 164 students from three high schools in Zaragoza (Spain) participated in the study. They were randomly assigned to (1) ‘Unlearning’, or (2) relaxation programme. Three assessment points were established: baseline, post-treatment and a 4-month follow-up. The outcome variables were the subscales of the ‘Attitudes Toward Social Aggression Scale’. Mindfulness and compassion were assessed as secondary outcomes.Results: ‘Unlearning’ did not produce changes in the primary outcomes, but significant effects were observed post-treatment in self-compassion; and in the follow-up, in self-compassion and mindfulness. The control group did not experience any change post-treatment, but a significant effect in mindfulness was observed in the follow-up. The intergroup analyses indicated that ‘Unlearning’ improved self-compassion, both post-treatment (t = −2.48, p = 0.014) and after 4-months (t = −2.03, p = 0.044), although these results were not statistically significant after correcting for multiple comparisons.Conclusion: ‘Unlearning’ did not produce significant reductions in aggressive attitudes compared to the control group. The low baseline levels may have hindered the efficacy of the interventions. ‘Unlearning’ showed potential to improve self-compassion, which is related to nonviolence, and this may have positive implications for the adolescents. Future interventions should include teachers and families to enhance the effectiveness of the programmes.

A Comparison of Acupuncture with Advice and Exercises on the Symptomatic Treatment of Osteoarthritis of the Hip – a Randomised Controlled Trial

2001 ◽  
Vol 19 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Roisin Haslam
Keyword(s):  
Controlled Trial ◽  
Randomised Trial ◽  
Symptomatic Treatment ◽  
Post Treatment ◽  
Control Group ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Randomised Controlled

Acupuncture is becoming a common technique within the physiotherapy profession as a treatment modality for pain relief; however, few randomised controlled trials have been undertaken to assess the effectiveness of acupuncture, particularly in the treatment of osteoarthritis (OA) of the hip. Therefore, a randomised trial to compare the effectiveness of acupuncture with advice and exercises on the symptomatic treatment of OA of the hip was carried out. Thirty-two patients awaiting a total hip arthroplasty were randomly allocated to either the experimental group, (A), to have six sessions of acupuncture each lasting up to 25 minutes, or the control group, (B), to be given advice and exercises for their hip over a six week period. Group A consisted of three men and 13 women, and group B consisted of four men and eight women. The average age in group A was 66 years and in group B it was 68 years. Patients were assessed for pain and functional ability, using a modified version of the WOMAC questionnaire, pre-treatment, immediately post-treatment and at eight weeks post-treatment. The pre-treatment WOMAC scores in the two groups were similar (p=0.85). There was a significant improvement in group A (decrease in WOMAC score) immediately post-treatment (p=0.002) and this was maintained at the eight-week follow-up (p=0.03). There were no significant changes in group B. When the changes in WOMAC scores were compared between groups, a significantly greater improvement was found between pre-treatment and immediately post-treatment in group A, compared with group B (p=0.02). The changes between pre-treatment and the eight-week follow-up also showed a significant improvement in group A compared with group B (p=0.03). In conclusion, this trial supports the hypothesis that acupuncture is more effective than advice and exercises in the symptomatic treatment of OA of the hip.

scholarly journals A Long-Term Follow-Up Programme for Maintenance of Motor Function after Stroke: Protocol of the life after Stroke—The LAST Study

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Torunn Askim ◽  
Birgitta Langhammer ◽  
Hege Ihle-Hansen ◽  
Jon Magnussen ◽  
Torgeir Engstad ◽  
...  
Keyword(s):  
Motor Function ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Long Term Follow Up ◽  
Randomised Controlled

Background. There are no evidence-based strategies that have been shown to be superior in maintaining motor function for months to years after the stroke. The LAST study therefore intends to assess the effect of a long-term follow-up program for stroke patients compared to standard care on function, disability and health.Design. This is a prospective, multi-site randomised controlled trial, with blinded assessment 18 months after inclusion. A total of 390 patients will be recruited and randomised to a control group, receiving usual care, or to an intervention group 10 to 16 weeks after onset of stroke. Patients will be stratified according to stroke severity, age above 80, and recruitment site. The intervention group will receive monthly coaching on physical activity by a physiotherapist for 18 consecutive months after inclusion.Outcomes. The primary outcome is motor function (Motor Assessment Scale) 18 months after inclusion. Secondary outcomes are: dependency, balance, endurance, health-related quality of life, fatigue, anxiety and depression, cognitive function, burden on caregivers, and health costs. Adverse events and compliance to the intervention will be registered consecutively during follow-up.

scholarly journals Group interpersonal psychotherapy for depression in rural Uganda: 6-month outcomes

2006 ◽  
Vol 188 (6) ◽  
pp. 567-573 ◽  
Author(s):  
Judith Bass ◽  
Richard Neugebauer ◽  
Kathleen F. Clougherty ◽  
Helen Verdeli ◽  
Priya Wickramaratne ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Controlled Trial ◽  
Health Benefit ◽  
Interpersonal Psychotherapy ◽  
Control Group ◽  
Depression Symptom ◽  
Treatment As Usual ◽  
Randomised Controlled

BackgroundA randomised controlled trial comparing group interpersonal psychotherapy with treatment as usual among rural Ugandans meeting symptom and functional impairment criteria for DSM–IV major depressive disorder or sub-threshold disorder showed evidence of effectiveness immediately following the intervention.AimsTo assess the long-term effectiveness of this therapy over a subsequent 6-month period.MethodA follow-up study of trial participants was conducted in which the primary outcomes were depression diagnosis, depressive symptoms and functional impairment.ResultsAt 6 months, participants receiving the group interpersonal psychotherapy had mean depression symptom and functional impairment scores respectively 14.0 points (95% CI 12.2–15.8; P < 0.0001) and 5.0 points (95% CI 3.6–6.4; P < 0.0001) lower than the control group. Similarly, the rate of major depression among those in the treatment arm (11.7%) was significantly lower than that in the control arm (54.9%) (P < 0.0001).ConclusionsParticipation in a 16-week group interpersonal psychotherapy intervention continued to confer a substantial mental health benefit 6 months after conclusion of the formal intervention.

scholarly journals The Effect of Patient’s Choice of Cognitive Behavioural or Psychodynamic Therapy on Outcomes for Panic Disorder: A Doubly Randomised Controlled Preference Trial

2020 ◽  
pp. 1-12
Author(s):  
Martin Svensson ◽  
Thomas Nilsson ◽  
Sean Perrin ◽  
Håkan Johansson ◽  
Gardar Viborg ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Psychodynamic Therapy ◽  
Post Treatment ◽  
Work Status ◽  
Random Assignment ◽  
Treatment Assessment ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Preference Trial

<b><i>Introduction:</i></b> It remains unclear whether offering psychiatric patients their preferred treatment influences outcomes at the symptom level. <b><i>Objective:</i></b> To assess whether offering patients with panic disorder with/without agoraphobia (PD/A) a choice between 2 psychotherapies yields superior outcomes to random assignment. <b><i>Methods:</i></b> In a doubly randomised, controlled preference trial (DRCPT), 221 adults with PD/A were randomly assigned to: choosing panic-focused psychodynamic therapy (PFPP) or panic control treatment (PCT; a form of cognitive behavioural therapy); random assignment to PFPP or PCT; or waiting list control. Primary outcomes were PD/A severity, work status and work absences at post-treatment assessment. Outcomes at post-treatment assessment, 6-, 12-, and 24-month follow-ups were assessed using segmented multilevel linear growth models. <b><i>Results:</i></b> At post-treatment assessment, the choice and random conditions were superior to the control for panic severity but not work status/absences. The choice and random conditions did not differ during treatment or follow-up for the primary outcomes. For panic severity, PCT was superior to PFPP during treatment (standardised mean difference, SMD, –0.64; 95% confidence interval, CI, –1.02 to –0.25); PFPP was superior to PCT during follow-up (SMD 0.62; 95% CI 0.27–0.98). There was no allocation by treatment type interaction (SMD –0.57; 95% CI –1.31 to 0.17). <b><i>Conclusions:</i></b> Previous studies have found that offering patients their preferred treatment yields small to moderate effects but have not employed designs that could rigorously test preference effects. In this first DRCPT of 2 evidence-based psychotherapies, allowing patients with PD/A to choose their preferred treatment was not associated with improved outcomes. Further DRCPTs are needed.

scholarly journals Acupoint catgut embedding regulates GABA-Glutamate of menopausal panic disorder patients: protocol for a vivo study

2019 ◽  
Author(s):  
Guizhen Chen ◽  
Shuo Zhang ◽  
Xue Wang ◽  
Xiaokang Xu ◽  
Zhen Zeng ◽  
...  
Keyword(s):  
Amino Acid ◽  
Panic Disorder ◽  
Panic Attack ◽  
Rating Scale ◽  
Intervention Group ◽  
Post Treatment ◽  
Control Group ◽  
Routine Test ◽  
1H Mrs

Abstract Background: Around 10% of general population suffer from panic attack (PD), and menopausal women are high-risk group of PD. PD severely effects patients’ living quality and social function because of its sudden onset and strong sense of impending death. The aim of this study is to investigate the pathogenesis, physio-pathology characters and seek for valid therapeutic measures. Methods: A parallel designed, exploratory randomized controlled trial with 7:3 allocation to intervention group (contains Group Implantation and Group Medication) versus control group. The included women of Group Implantation will receive a biweekly acupoint catgut embedding treatment during 12 consecutive weeks in the following predefined acupuncture points: BL23, SP6, RN4, BL18, ST36 and BL20. All acupuncturists are medical doctors educated in acupuncture. The included women of Group Medication will take 0.4mg Alprazolam tablet orally, 1 tablet a time, 3 times a day. There is a study period of 3 months and a follow-up period of 1 month for each group. The primary outcomes are measured by the following therapeutic indexes: frequency of panic attack during observation period (3 months) and during follow-up period (1 month), Panic Disorder Severity Score (PDSS), Panic Associated Symptoms Score (PASS) and HAMA Score. The secondary outcomes are measured by the following therapeutic indexes: SLC-90 Score, Chinese Menopause Rating Scale Score. And there are several Biomarker Indexes: fMRI and 1H-MRS scans taken pretherapy and post-treatment, free amino acid and E2 of peripheral blood tested pretherapy and post-treatment. Moreover, there are also safety indexes: blood routine test, urine routine test, stool routine test, liver function (ALT), kidney function (serum creatinine) and electrocardiogram. Discussion: In this study, we are meant to reveal neural activity and amino acid metabolism of PD patients, and the internal relationship with clinic curative effect by using fMRI and 1H-MRS. The results of this study may provide a novel treatment regimen for PD patients. Trial registration: Chinese Clinical Trial Registry, ChiCTR-INR-16009724, registered in November 2016. Keywords: Acupoint catgut embedding, GABA-Glutamate, Menopausal, Panic disorder, Protocol

Short- and Long-Term Effects of Late Maxillary Advancement With the Liou-Alt-RAMEC Protocol in Unilateral Cleft Lip and Palate

2018 ◽  
Vol 56 (2) ◽  
pp. 159-167 ◽  
Author(s):  
Maria Costanza Meazzini ◽  
Laura B. Zappia ◽  
Chiara Tortora ◽  
Luca Autelitano ◽  
Roberto Tintinelli
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Long Term Results ◽  
Control Group ◽  
Class Iii ◽  
Maxillary Protraction ◽  
Long Term Follow Up ◽  
Short And Long Term

Objective: The objective of this retrospective longitudinal study was to evaluate short- and long-term results of the application of the Liou Alt-RAMEC (alternate rapid maxillary expansion and constriction) technique, a late orthopedic maxillary protraction technique, with intraoral anchorage, in patients with cleft. Materials and Methods: Twenty-six patients with unilateral cleft lip and palate (UCLP) were consecutively treated with the Alt-RAMEC technique. The average age of the patients was 11.7 years (10.3-13.2 years) before protraction and 18.3 years (17.4-21.1 years) at long-term follow-up. A sample of nontreated patients with UCLP was used as a control group. It was matched for sex, skeletal class III, and age (11.3 years). The control sample had records at the end of growth (18.7 years). Results: The sagittal advancement of A-point, after the application of the technique, was 5.7 (2.17) mm. Some mandibular dentoalveolar and positional adaptation was noted. The position of the maxilla was stable in the long term. On the other hand, the UCLP control group showed hardly any growth at the maxillary level during the long-term follow-up period. Conclusion: Our results showed that the Alt-RAMEC technique, performed at the correct time, with a double-hinged expander, followed by class III spring or elastic traction, 24 hours per day, allows for satisfactory maxillary protraction, with, at this stage, apparently stable long-term results. Nevertheless, as only 50% of the patients had long-term follow-up data, we are still unable to predict the percentage of patients which will not eventually need orthognathic surgery.

scholarly journals Psychotherapy plus antidepressant for panic disorder with or without agoraphobia

2006 ◽  
Vol 188 (4) ◽  
pp. 305-312 ◽  
Author(s):  
Toshi A. Furukawa ◽  
Norio Watanabe ◽  
Rachel Churchill
Keyword(s):  
Panic Disorder ◽  
Acute Phase ◽  
Antidepressant Treatment ◽  
Combined Therapy ◽  
Short And Long Term ◽  
Using Data ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
Acute Phase Treatment

BackgroundPanic disorder can be treated with psychotherapy, pharmacotherapy or a combination of both.AimsTo summarise the evidence concerning the short- and long-term benefits and adverse effects of a combination of psychotherapy and antidepressant treatment.MethodMeta-analyses and meta-regressions were undertaken using data from all relevant randomised controlled trials identified by a comprehensive literature search. The primary outcome was relative risk (RR) of response.ResultsWe identified 23 randomised comparisons (21 trials involving a total of 1709 patients). In the acute-phase treatment, the combined therapy was superior to antidepressant pharmacotherapy (RR=1.24, 95% CI 1.02–1.52) or psychotherapy (RR=1.16, 95%CI 1.03–1.30). After termination of the acute-phase treatment, the combined therapy was more effective than pharmacotherapy alone (RR=1.61, 95% CI 1.23–2.11) and was as effective as psychotherapy (RR=0.96, 95% CI 0.79–1.16).ConclusionsEither combined therapy or psychotherapy alone may be chosen as first-line treatment for panic disorder with or without agoraphobia, depending on the patient's preferences.

scholarly journals Telephone-Based Coaching and Prompting for Physical Activity: Short- and Long-Term Findings of a Randomized Controlled Trial (Movingcall)

2019 ◽  
Vol 16 (14) ◽  
pp. 2626 ◽  
Author(s):  
Xenia Fischer ◽  
Jan-Niklas Kreppke ◽  
Lukas Zahner ◽  
Markus Gerber ◽  
Oliver Faude ◽  
...  
Keyword(s):  
Physical Activity ◽  
Controlled Trial ◽  
Vigorous Physical Activity ◽  
Structured Interview ◽  
Group Differences ◽  
Control Group ◽  
Short And Long Term ◽  
Telephone Coaching

This study analyzed the short- and long-term efficacy of telephone coaching and short message service (SMS) prompting for physical activity (PA) promotion. Two-hundred-and-eighty-eight adults (age: 42 ± 11 years) were assigned randomly to three intervention arms: The intervention groups received 12 bi-weekly telephone calls with (coaching and SMS group) or without (coaching group) additional SMS prompts (n = 48 SMS). The control group received a single written PA recommendation. Self-reported and objective moderate-to-vigorous physical activity (MVPA) levels were assessed by a structured interview and by accelerometer at baseline, after the intervention (6 months), as well as after a no-contact follow-up (12 months). At post-test, self-reported MVPA increased by 173 min/week (95% CI 95 to 252) in the coaching group and by 165 min/week (95% CI 84 to 246) in the coaching and SMS group compared to control. These group differences remained similar in the follow-up test. For the objectively assessed MVPA, the coaching group increased by 32 min/week (95% CI 0.1 to 63) and the coaching and SMS group by 34 min/week (95% CI 1.6 to 66) compared to the control group. In the follow-up test, the objective MVPA levels of the intervention groups no longer differed from baseline, but group differences persisted as the control group decreased below baseline. Additional SMS prompts did not result in a further increase in PA. Telephone coaching can be considered an effective tool for PA promotion.

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